NPIMap

Organization Active NPI

Redle Psychological Services LLC

  • Clinical Psychologist
  • Cuyahoga Falls, OH
National Provider Identifier
1891807632
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
5989 Issued in OH
Legal business name
REDLE PSYCHOLOGICAL SERVICES LLC
Practice address
2321 2ND Street
Suite 118
Cuyahoga Falls, OH 44221
Phone
(330) 926-0760
Fax
(330) 926-1944
NPI assigned
Aug 31, 2006
Last updated
Aug 22, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Stephen Mary Redle, PHDNPI 1346316742
Title
Managing Member
Phone
(330) 926-0760

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 5555 OH
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 5989 OH Primary
Clinical PsychologistGroup: 193200000X MULTI-SPECIALTY GROUP 103TC0700X 5934 OH

Addresses

Primary practice location

2321 2ND Street
Suite 118
Cuyahoga Falls, OH 44221

Mailing address

2321 2ND Street
Suite 118
Cuyahoga Falls, OH 44221
Phone (330) 926-0760

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in OH

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050307000513 OH Part B Supplier - Clinic/Group Practice 8921052523 Receives reassigned benefits from 2 practitioners
1 other NPI on this enrollment
Practice locations: Kent, OH; Cuyahoga Falls, OH; Doylestown, OH; Fairlawn, OH; Geneva, OH; Hudson, OH; Jefferson, OH; Wadsworth, OH…

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
FHS Brimfield Inc2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners & affiliated clinicians

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1891807632",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2321 2ND STREET",
            "address_2": "SUITE 118",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "44221",
            "telephone_number": "330-926-0760",
            "fax_number": "330-926-1944"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2321 2ND STREET",
            "address_2": "SUITE 118",
            "city": "CUYAHOGA FALLS",
            "state": "OH",
            "postal_code": "44221",
            "telephone_number": "330-926-0760",
            "fax_number": "330-926-1944"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REDLE PSYCHOLOGICAL SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "REDLE",
        "authorized_official_first_name": "STEPHEN",
        "authorized_official_middle_name": "MARY",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "330-926-0760",
        "authorized_official_credential": "PHD"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5555",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5989",
            "primary": true
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychologist, Clinical",
            "state": "OH",
            "license": "5934",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cuyahoga Falls, OH

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.